Environmental Health Section

Transcripción

1 Environmental Health Section EHS Circular Letter # To: From: Local Health Directors and Chief Sanitarians Francesca Provenzano, Health Program Supervisor Lead and Healthy Homes Program Date: May 30, 2012 Subject: The Connecticut Efficient Healthy Homes Initiative Do you know that there is a Healthy Homes Initiative in your town? The Connecticut Efficient Healthy Homes Initiative (CTEHHI) is a statewide, collaborative effort of the United Illuminating (UI) Company, Connecticut Light & Power, the Energy Efficiency Fund, and a network of community partners. What services do they provide? The Initiative provides no to low-cost weatherization, energy efficiency and health and safety improvements to income eligible residents through CTEHHI. (Pamphlet attached) But what is it really worth? With an average value of up to $9,750 per home, CTEHHI can install things like: Compact fluorescent light bulbs (CFLs) Water- and energy-saving faucet aerators and showerheads Insulation and appliance upgrades Heating and cooling system evaluation Smoke and carbon monoxide detectors Kitchen and bath ventilation Lead paint, asbestos, and mold assessment with some remediation Who should you tell about this Initiative? Homeowners and rental property owners Low-income renters Everyone! Encourage them to contact the Initiative to see what services they qualify for under this program. For more information contact: UI s WISE USE Hotline WISE USE Visit Chuck Winchell cc: Suzanne Blancaflor, M.S., M.P.H. Chief, Environmental Health Section Ellen Blaschinski, R.S., M.B.A., Chief, Regulatory Services Branch Phone: (860) Fax: (860) VP: (860) Capitol Avenue, P.O. Box MS#51LED Hartford, Connecticut Affirmative Action/Equal Opportunity Employer

2 CT Efficient Healthy Homes Initiative Customer Application Home Energy Solutions (HES) can make your home more energy efficient, comfortable, and environmentally friendly. For a co pay of $75, an energy expert will visit your home, providing valuable energy saving services and information. The $75 will be waived for customers who are income qualified. To be considered for Home Energy Solutions, Home Energy Solutions Income Eligible (HES IE), or CT Efficient Healthy Homes (CTEHHI) services made possible by Connecticut s Energy Efficiency Fund, please complete this application. All applicants who are renters must have their landlords complete the back of this application. SECTION 1: ALL APPLICANTS MUST COMPLETE THIS SECTION (Please Print) First Name: Last Name: Daytime Phone: Address: Unit # City: Zip: Check ALL that apply: Single Family Apartment Condo Duplex Year Round Seasonal Use Only Number of units in building: Number of stories: Age of home (check one): Pre Post 1978 Heated square footage of home: sq ft Are the units in your building individually heated and cooled? Yes No: Central Boiler/Furnace Don t know Primary fuel type: Electric Gas Oil Propane Primary heat type: Forced hot air Hot water baseboard Hot water type: Electric Gas Oil Propane Other: Age of system: years UI/CLP Account #: Gas Company (check one): Yankee SCG CNG Account #: Oil Company: Central Air Conditioning: Yes Age: years No Please check one: UI/CLP has permission to release billing information to the vendor conducting HES services in my home to evaluate savings as a result of How did you hear about the HES program? Bill insert Direct mail Radio/TV Referral Other: weatherization measures installed. Do you: Own Rent* (Your landlord must complete the back of I do not authorize the release of my billing information. this application.) My signature below indicates that I understand that if I am found to be eligible for an energy assessment of any appliances, it is required that I own them, and that I will only participate in energy assessments concerning appliances that I own. I acknowledge and agree that (i) I am not to receive or retain any Class III renewable energy credits, or any environmental credits or benefits, in connection with this program, and such credits shall be retained by UI or CL&P for the benefit of their customers through the Connecticut Energy Efficiency Fund, and (ii) Forward Capacity Market credits/benefits/payments associated with my participation in this program are hereby assigned to UI or CL&P. Print Name: Signature: Date: SECTION 2: INCOME ELIGIBLE APPLICANTS ONLY To qualify for these services at no charge, the gross annual income for your household must be at or below 60% of state median (see chart below). Please fax current copies of any one of the following to : Social Security, Supplemental Security Income, or Department of Income Management budget sheet; energy assistance award letter; unemployment letter; last four (weekly) or last two (bi weekly) pay stubs, along with Social Security card, birth certificate, or passport; Schedule C of tax return (self employed only). UI and CLP reserve the right to verify income before services are provided. Please note that if you income qualify for HES IE or CTEHHI, you also qualify for UI s winter protection program. Total weekly income (gross) of all household members: $ Number of elderly (60+ years): Number of disabled: Number of children (<6 years): Were you approved to receive a fuel assistance benefit in the past year? Yes No Don t know If you applied, please check which agency you signed up with: CAA NH ABCD TEAM Other: (PLEASE INITIAL) My initials indicate that I understand that my eligibility for energy conservation services under the HES Income Eligible Program requires my income to be within the limits specified, and that my income is within such limits. Please mail completed form to: WISE USE, 157 Church Street, PO Box 1564, MS 1 6B, New Haven, CT (or) Fax to (203) Yearly Income Limits (All Household Members) Family Size Max. Annual Income 7 $82, Additional eligibility requirements may apply. Referring Agency (if applicable) Please note that filling out this form does not automatically qualify you for the HES program. If you are eligible, you will be notified via letter or phone. An authorized adult must be present during the assessment and to provide access to the premises. The fee for non income eligible customers will be collected at the time of service as applicable. This program is subject to change based on available funding, and we reserve the right to restrict services to homes that could benefit the most as a result of potential high customer participation and over subscription. For any questions or concerns, please call WISE USE ( ). LANDLORD/PROPERTY OWNER MUST COMPLETE REVERSE

3 CT Efficient Healthy Homes Initiative Property Owner Agreement SECTION 3: ALL RENTERS YOUR LANDLORD COMPLETE THIS SECTION I am the owner or authorized agent of the residential building located at: I hereby give permission to UI, or to their authorized agents, to perform an energy conservation needs assessment and to install energy efficient measures at the above referenced location, as well as in all of the units in the building, as listed in below (if not single family). I certify that, for a reasonable period of time after weatherization work has been completed at this building, the tenants in the weatherized units (including households paying for their energy through their rent) will not be subjected to rent increases unless those increases are demonstrably related to matters other than the weatherization work performed. Print Name: Signature: Date: Address: Phone Number: ( ) Resident Name Address and Unit # UI/CLP Account # (if available) SECTION 4: INCOME ELIGIBLE RENTERS ONLY YOUR LANDLORD MUST COMPLETE THIS SECTION For 2 4 unit multifamily buildings, at least 50% of the tenants must be eligible. For buildings with 5 units or more, at least 66% of the tenants must be eligible. I. Standard Home Energy Solutions Income Eligible (HES IE) Services, Free of Charge The following energy efficiency services will be provided at no cost to you, the landlord, or your tenant through the Connecticut Energy Efficiency Fund and HES IE. These services can help reduce energy consumption in the residence(s). You must agree to grant UI and its representatives permission to enter the above referenced property in order to provide the following services as applicable: Lighting/fixture replacement with energy efficiency compact fluorescent lights Weatherization: diagnostic air and duct sealing, weatherstripping, and door sweeps Water efficiency measures: low flow aerators, showerheads, and pipe wrap II. Additional Services In addition to the above referenced Standard HES IE Free of Charge services, UI and its representatives will evaluate the residence to determine if insulation, refrigerators, freezers, and dehumidifiers are inefficient and eligible for an upgrade to an energy efficient standard. If these upgrades are eligible and your (the landlord s) income meets the HES IE income eligibility guidelines, AND you reside at the residence listed, these upgrades will be provided to the residence listed at no cost. If your (the landlord s) income exceeds income eligibility guidelines, OR you do not reside in the residence listed, you, as the landlord, are required to contribute a copayment of 20% of total material costs or $500 (whichever is less) per dwelling unit. I, the owner or authorized agent of the above listed residence agree (PLEASE INITIAL appropriate line): To allow only for Standard HES IE, as described in Section I, to be performed at no charge to my tenant(s) or myself. I reside at the above listed residence AND meet program eligibility requirements, and agree to allow for Standard HES IE as described in Section I to be performed at no charge to my tenant(s) or myself, AND to have additional services as described in Section II be performed, all at no charge to my tenant(s) and/or myself. (Proof of income required.) I do not reside at the above listed residence, AND/OR do not meet program income eligibility requirements, and agree to allow for Standard HES IE services, as described in Section I, to be performed at no charge to my tenant or myself, AND agree to the evaluation of insulation, refrigerator, freezer, and dehumidifier upgrades with my required co payment of 20% or $500 per dwelling unit as described in Section II. C0071 Rev

4 Connecticut Efficient Healthy Homes Initiative Making housing safe, healthy, and environmentally sustainable throughout Connecticut A Healthy Home is: L dry L clean L pest-free L safe L contaminant-free L properly ventilated L maintained L energy efficient Most people spend over 90 percent of their time indoors, which is why it s so important to be aware of hidden risks that may exist in your home, such as carbon monoxide, lead, pests, mold and moisture. These issues cause poor indoor air quality, which can trigger asthma and create other serious health challenges. The Connecticut Efficient Healthy Homes Initiative (CTEHHI) can help you identify and address these risks in your home, while making your home more energy efficient so you can save money. CTEHHI is a community-based, statewide program carried out in collaboration with the Energy Efficiency Fund, its utility partners and nonprofit, municipal, and healthcare partners across Connecticut. During the Visit Specialists will assess your home s energy efficiency and perform a wide range of weatherization services, such as: L Installing compact fluorescent light bulbs (CFLs) L Caulking drafts, cracks and leaks around your windows, doors, plumbing and outlets L Installing water-saving faucet aerators and showerheads Specialists will conduct an energy assessment to determine if your home is eligible for additional energy-saving measures. In addition, specialists will complete a Healthy Homes Checkup to identify health and safety issues that may be present in your home, such as: L Is your furnace operating safely? L Is there mold or excessive moisture in your home? L Do you have life-saving carbon monoxide detectors? L Do you have exhaust fans in your bathroom and kitchen? L Do you have household products like chemicals or pesticides in your home that could make you sick? Based on the results of these assessments, you may be eligible to have some of these risks corrected in a second visit. The specialist may also refer you to partner programs across the state that can help with issues such as lead paint, and will provide you with tips on easy ways to keep your home safe and healthy for you and your family. Are You Eligible? CTEHHI follows U.S. Department of Energy requirements for eligibility. Start by locating your family size on the chart below and the dollar amount next to it. If your family s combined gross annual income is this amount or less, you are income-eligible for the program (income verification is required). Income Guidelines for the Fuel Season Family Size Gross Annual Income 7 $82, Additional eligibility requirements may apply. If you have received weatherization services under the U.S. Department of Energy Weatherization Assistance Program since September 30, 1994, you are not eligible to participate in CTEHHI. Checking for contaminants in the home. I heard about the program through a local community event and signed up to make my home more efficient and safe for my children. Tahania Cunningham, New Haven If you are not eligible for CTEHHI, you can still lower your energy costs through Home Energy Solutions programs. Call the number below for more information. How Do I Apply? To sign up for CTEHHI, please call WISE USE ( ) and mention Healthy Homes or CTEHHI. Landlords are required to grant permission for tenants in their buildings. For more information or to apply online, visit healthyhomes Ensuring proper ventilation. CTEHHI is supported by the Energy Efficiency Fund in partnership with the Connecticut Utility Companies, Bridgeport Neighborhood Trust, the City of New Haven, the City of Bridgeport, Connecticut Children s Medical Center LAMPP Project, Connecticut Department of Public Health, Connecticut Housing Finance Authority, L. Wagner & Associates, NauVEL, NeighborWorks New Horizons, and Yale-New Haven Children s Hospital Regional Lead Treatment Center. C0188 8/11

Dear Valued Customer: Eversource is offering free weatherization services designed to lower your energy bill. The HES-IE program is available to renters or homeowners with a GROSS income at or below 60

Memo To: ERF Members The Employees Retirement Fund has been asked by Deferred Compensation to provide everyone that has signed up to retire with the attached information. Please read the information from

Citizens Energy /CITGO Petroleum Oil Heat Program 2015 EXPLANATION OF GRANT TERMS & CONDITIONS FOR BOARD MEMBERS If Awarded A Grant, HDFC s Agree To The Following Grant Regulations: This grant only covers

Guide to Health Insurance Part II: How to access your benefits and services. 1. I applied for health insurance, now what? Medi-Cal Applicants If you applied for Medi-Cal it will take up to 45 days to find

[CITY SEAL/EMBLEM] The Capital City of the Palm Beaches TITLE VI COMPLAINT FORM Title VI of the 1964 Civil Rights Act requires that "No person in the United States shall, on the ground of race, color or

Patchogue, New York 11772 Required Documentation for Charity Care The completed signed application listing all family members, must be filled out and returned to the Patient Financial Services Department

San Luis Valley Health s Behavioral Health department offers a sliding fee discount program to eligible patients. If you would like more information, please call 589-8008, or ask one of our Admitting Clerks

Voter Information Guide and Sample Ballot Special Election San Bernardino Mountains Community Hospital District Tuesday, June 4, 2013 Elections Office of the Registrar of Voters 777 East Rialto Ave. San

The following is an explanation of the procedures for calling a special meeting of the shareholders. Enclosed are copies of documents, which you can use for your meeting. If you have any questions about

Welcome to the CU at School Savings Program! Thank you for your interest in Yolo Federal Credit Union s CU at School savings program. This packet of information has everything you need to sign your child

New Health Insurance Marketplace Coverage Options and Your Health Coverage Form Approved OMB No. 1210-0149 (expires 11-30-2013) PART A: General Information When key parts of the health care law take effect

GOOD NEWS!!! HOUSING AUTHORITY HAS INCREASED ITS PAYMENT STANDARDS FREQUENTLY ASKED QUESTIONS (FAQs) FOR TENANTS 1. WHAT IS THE GOOD NEWS? Effective February 1, 2016, the Housing Authority has increased

Daly Elementary Family Back to School Questionnaire Dear Parent(s)/Guardian(s), As I stated in the welcome letter you received before the beginning of the school year, I would be sending a questionnaire

Learning Masters Fluent: Wind, Water, and Sunlight What I Learned List the three most important things you learned in this theme. Tell why you listed each one. 1. 2. 3. 22 Wind, Water, and Sunlight Learning

Down Payment Assistance Application Packet Please assure that all needed items are attached and complete. Please note that your application will not be considered until all documents are received. 1. Down

MajestaCare Healthy Baby Program Helping you have a healthy baby Para que tenga un bebé saludable Your baby s provider After your baby becomes a member of MajestaCare health plan, you will get a letter

TITLE VI COMPLAINT FORM Before filling out this form, please read the Arcata and Mad River Transit System Title VI Complaint Procedures located on our website or by visiting our office. The following information

The ADE Direct Certification User Guide is a tool for authorized ADE and school district personnel to use in conjunction with the ADE Direct Certification website. 1 This User Guide is a reference guide

Residential Rental Application Office use only: DATE SUBMITTED: Anyone using this application WILL NOT be charged a broker fee. Make sure that you bring copies of all the required documents, we will not

ALERT Customers who received a premium tax credit in 2014 and are preparing to renew his/her health coverage for 2016 are required to have filed his/her 2014 taxes in order to continue receiving his/her

PAGE PROGRAM MINIMUM ELIGIBILITY REQUIREMENTS Applicants who wish to apply to either program MUST meet all of the following criteria: Annual income per client household size must fall within the following

INSTRUCTIONS FOR COMPLETING THE UA_SGE_FT_03_FI_IE FORM REGARDING NATURAL PERSONS DATA FOR THE UA SUPPLIERS DATABASE This form is for use by both Spanish and foreign natural persons. Due to the new requirements

Our hiring policy is simple: WE FOLLOW THE LAW! This company hires lawful workers only U.S. citizens or nationals and non-citizens with valid work authorization without discrimination. Federal immigration

FAQ This tax season, certain Medicaid members will receive Form 1095-B from the Georgia Medicaid/ PeachCare for Kids program. Select members who receive their healthcare coverage through Fee-for-Service

INSTRUCTIONS FOR COMPLETING THE UA-SGE-FT-05-FI-IE FORM REGARDING NATURAL PERSONS DATA FOR THE UA SUPPLIERS DATABASE This form is for use by both Spanish and foreign natural persons. Due to the new requirements

Family Health History Project Pre-Survey What is family health history? Family health history is information about diseases that run in your family, as well as the eating habits, activities, and environments

EXPANDING HORIZONS EXPAND HORIZONS IS WHAT PAUL CUFFEE SCHOOL DOES. When you gaze out at the horizon, what do you see? You see where one vista ends and another one begins. You think POSSIBILITIES Selected

manual de servicio nissan murano z51 Reference Manual To understand featuring to use and how to totally exploit manual de servicio nissan murano z51 to your great advantage, there are several sources of

The Home Language Survey (HLS) and Identification of Students The Home Language Survey (HLS) is the document used to determine a student that speaks a language other than English. Identification of a language

Please download the attached Barking Dog Incident Log Take the time to fill out the log completely, When at least seven (7) days of habitual barking are documented, the log should be returned to Animal

FORM 16-1 AUTHORIZATION FOR USE OR DISCLOSURE OF HEALTH INFORMATION Completion of this document authorizes the disclosure and use of health information about you. Failure to provide all information requested